IDET: INTRADISCAL ELECTROTHERMAL THERAPY

What is a disc and how is IDET helpful?

The discs are the cushion-like pads that separate the vertebral bones of your spine. When a disc degenerates, tears or herniates, it can cause pain in the back, buttocks, hips and legs. Discography is the gold standard to confirm or deny the disc itself as a source of pain. If it is determined that a particular disc is the source of your pain, your physician can advise you on an appropriate treatment method such as intradiscal electrothermal therapy (IDET). IDET is a minimally invasive procedure which involves guiding a wire into a disc which is then heated in order to help heal tears within the disc and reduce pain.

What happens during the procedure?

An IV will be started so that antibiotics (to prevent infection) and relaxation medication can be given. You will lie face down on a procedure table. The physician will use fluoroscopic (x-ray) guidance to visualize the spine. The physician will scrub your skin with sterile soap and place a drape on your low back. The physician will numb a small area of skin with anesthetic medication. After the anesthetic has been given time to be effective, the physician will then direct a very small needle using fluoroscopic guidance into the disc. You may feel temporary discomfort as the needle passes through the outside of the disc. The next step is to insert the electrothermal wire through the needle into the disc. The heating element is activated, and the heat then increased slowly over the next 15 minutes. As the heat increases into the treatment range, you might experience some discomfort. Your physician will monitor your responses during the procedure to insure that any discomfort you feel is well controlled.

What happens after the procedure?

Immediately after the procedure, you will go to a recovery area where you will be monitored for approximately 30 minutes. After discharge, you will not be able to drive the day of the procedure.

For the first 7-10 days after your procedure, you may experience a moderate increase in back pain; do not expect your typical pain to disappear immediately. Rest, ice, and anti-inflammatory and/or pain medications may help minimize this discomfort. Any new or unusual symptoms (ie. fever, rash, or numbness) should be reported to your physician immediately. If you experience a marked reduction in pain, do not exert yourself during this time as this may negatively affect the overall outcome. Housework, lifting, or bending should not be done. In addition, you should not return to work during the first week even if you have a sedentary job. You should plan to discuss your return to work with your physician if you have a more active job. Note, while you should generally be resting during the first week, short walks up to 15 to 20 minutes are permitted.

For the first month after the procedure, your disc is continuing to heal. You may begin to feel a reduction in pain during this time however pain reduction usually occurs over 3 - 4 months. Anti-inflammatory medications and/or pain medication may be prescribed if needed to control any low back pain. Applying ice up to 20 minutes at a time 3-5 times a day is also advisable to reduce any discomfort.

During this first month, you must treat your back carefully. Absolutely no bending, twisting, or heavy lifting. No sport activities including running, biking, golf, tennis, skiing, etc. You do not have to abstain from sexual activity, but be careful not to exert your back. Your physician will guide you regarding rehabilitation exercises after your procedure. If you have been performing strenuous rehabilitation exercises before the procedure, you will not immediately return to that level of exercise, but to a more moderate level that will be gradually increased as you improve. Be sure to ask your physician for a post-operative exercise program.

In the 2nd, 3rd, and 4th months after the procedure, you should continue to maintain good body mechanics ie. avoiding bending improperly. Your physician will help you advance your flexibility and strength. If you plan to return to athletic pursuits, specialized advanced training maybe undertaken to help achieve your goal.

General Pre-op and Post-op Instructions:

  • You will be scheduled at one of the facilities listed below. You will be at the facility approximately 1-1.5 hours total.
  • You will be required to have a responsible adult drive you home.
  • You should take your routine medications (ie. blood pressure, diabetic medications) the day of your procedure.
  • If you are taking Coumadin or blood thinners, please notify the office immediately.
  • You must not eat any food six hours prior to your appointment.
  • You may have sips of clear liquids up to two hours prior to your appointment
  • You may want to wear loose, comfortable clothing to your appointment.
  • You may return to your normal activities the day after your procedure, including returning to work.

Location of Procedures:

Desert Spine and Sports Phoenix office: 3700 N 24th Street, Ste 210. Phoenix, AZ 85016

Desert Spine and Sports Mesa office: 6636 East Baseline Rd Suite 101, Mesa, AZ 85206

If you need to reschedule this appointment, please give 24 hours notice and call 602-840-0681.